The role of pulmonary rehabilitation in improving quality of life among patients with Chronic Obstructive Pulmonary Disease (COPD) in India: a scoping review

Abstract

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a significant public health challenge, particularly in low- and middle-income countries, where it remains underdiagnosed and poorly managed. In India, barriers such as limited awareness, constrained diagnostic accessibility, and inadequate public health prioritization exacerbate disease burden. This study explores COPD awareness, educational initiatives, and the impact of pulmonary rehabilitation (PR) on patient outcomes within the Indian healthcare context. Methods A scoping review was conducted to examine COPD awareness, educational outreach, and knowledge dissemination in India. Literature was sourced from multiple databases following PRISMA-ScR guidelines. Studies were screened using Covidence, and data were synthesized narratively. Results The search identified 415 records, with 287 remaining after duplicate removal. Title and abstract screening excluded 228 non-relevant studies, leaving 59 for full-text review. Ultimately, 23 studies met the inclusion criteria. Methodological assessment supported the overall reliability of the included studies. Non-adherence emerged as a major barrier to effective COPD treatment. Pharmacist-led interventions were associated with improved medication adherence, symptom control, and reduced healthcare utilization costs. While PR is recognized as a beneficial intervention, its implementation is hindered by limited access and logistical challenges. COPD management in India remains constrained by limited public awareness, persistent stigma, inequitable healthcare access, and inadequate rehabilitation infrastructure. Systemic reforms integrating structured PR programs, targeted healthcare provider training, and policy-driven strategies are essential for improving COPD management. Conclusion Despite the substantial burden of COPD in India, this review highlights the lack of structured policies, government-led initiatives, and comprehensive public awareness programs. Systemic barriers impede early diagnosis, effective disease management, and PR integration. Sociocultural stigma, healthcare provider shortages, and infrastructure limitations further exacerbate disparities. Addressing COPD requires a multifaceted approach, including healthcare provider training, PR expansion, and culturally adapted education. Emerging digital and telemedicine-based interventions show potential in bridging accessibility gaps. While evidence indicates that PR significantly improves patient outcomes, accessibility challenges persist. Future policies must integrate telemedicine, targeted interventions, and financial support mechanisms to optimize COPD care. Large-scale, longitudinal studies are needed to evaluate the long-term efficacy of interventions and guide sustainable healthcare reforms. Registration This scoping review was not prospectively registered. Given that protocol registration is not typically required for scoping reviews under PRISMA-ScR guidance, registration was not undertaken.

The authors' abstract, as published at the source. BMC Pulmonary Medicine, 2026 · DOI ↗